Carpal Tunnel Syndrome: When To Consider Injections vs Surgery For Release?

The Best Treatment For CTS

Carpal tunnel syndrome (CTS) is a condition caused by repetitive movements in the wrist and hand. In particular, the median nerve in the hand and wrist is compressed or squeezed. Left untreated, the condition can worsen, making basic movements more difficult. Avoiding certain activities, using supportive braces, and taking over-the-counter (OTC) medications can all help improve symptoms. However, some people will need other medical interventions like injections or surgery to correct carpal tunnel.

The medical approach

Two of the most common medical treatments recommended for carpal tunnel syndrome include surgery or corticosteroids. While corticosteroids can also be taken as oral tablets, injections are more commonly used to treat pain in the wrist. Steroid shots should be administered in moderation to prevent adverse reactions. Typically, surgery is reserved for more severe cases and only explored after other treatment methods haven’t worked.

The case for injections

Surgery is usually reserved for patients with more serious CTS, but injections are often recommended for newly diagnosed patients. A recent study found that people who received local corticosteroid injections were less likely to need surgery within 5 years compared with placebo. Another study discovered that corticosteroid shots as a first-line treatment for patients with mild to moderate carpal tunnel syndrome also showed positive results. The study followed 2 groups, a subset that received an injection and a group that utilized nightly splinting for 6 weeks. The injection group noted better symptom improvement.

Possible side effects

As effective as injections can be, the treatment isn’t without potential side effects. Some patients may experience heightened blood sugar, weakening of the tendons, infection, or even an allergic reaction. Most commonly, patients may experience discomfort in the hours and days immediately following an injection. Receiving too many corticosteroid shots can also cause damage to the cartilage or tendons, making pain, discomfort, and range of motion worse.

The final word on injections

Deciding whether corticosteroid injections are an appropriate treatment solution shouldn’t be done lightly. A healthcare provider can help determine if pain or limited mobility are inhibiting quality of life enough to warrant a shot. Research is promising and suggests that opting for shots can minimize the need for surgery later on. However, remember that not everyone with carpal tunnel syndrome is a strong candidate for this treatment method.